Voluntary assisted dying is now lawful in Victoria

The Act contains what is arguably the world's most detailed and carefully laid out safeguards.

Key aspects of the provisions are:

• The person must be 18 years or over; and
• Be ordinarily resident in Victoria and an Australian citizen or permanent resident; and
• Have decision-making capacity in relation to voluntary assisted dying; and
• Be diagnosed with an incurable disease, illness or medical condition that:
  • is advanced, progressive and will cause death; and
  • is expected to cause death within 12 months; and
  • is causing suffering that cannot be relieved in a manner the person deems tolerable; and
• Doctors and other healthcare workers are not permitted to raise assisted dying — only to respond to formal patient requests.
• The person must make three formal requests, the second of which must be written and witnessed by two independent people.
• The person must make the request themselves. Nobody else is authorised to make the request, and the request cannot be made via an advance care directive.
• Ordinarily, the minimum timeframe between first request and opportunity to take the medication is ten days.
• The person must maintain decisional capacity at all three requests.
• Two doctors must reach independent assessments that the person qualifies.
• Only doctors who have completed specialist training for voluntary assisted dying may participate.
• Any healthcare worker may decline to participate for any reason, without penalty.
• A prescription dispensed for the purpose of voluntary assisted dying must be kept in a locked box and any unused portion returned to the pharmacy after death.
• The person must self-administer the medication; except if the person is unable to, a doctor may administer. An independent witness is required if the doctor administers.
• Establishment of an authority to receive assisted dying reports, to assess reports, and to refer unacceptable cases to disciplinary or prosecutorial authorities.
• For Parliament to review summary reports; twice in the first two years and annually thereafter; a formal review at five years.
   

More information about the Act and how to access voluntary assisted dying are available from Health Victoria.

 

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Full list of safeguards in Victoria's voluntary assisted dying framework

Access

1. Voluntary
2. Limited to 18 years and over
3. Residency requirement [Victorian resident and Australian citizen or permanent resident]
4. Limited to those with decision-making capacity
5. Must be diagnosed with condition that meets restrictive set of criteria [advanced, progressive and will cause death]
6. End of life is clearly defined [death expected within weeks or months, not more than 12 months]
7. End of life condition combined with requirement for suffering
8. All of the eligibility criteria must be met
9. Mental illness alone does not satisfy the eligibility criteria
10. Disability alone does not satisfy the eligibility criteria

Request

11. Must be initiated by the person themselves
12. No substitute decision makers allowed
13. Cannot be included as part of an advance directive
14. Health practitioner prohibited from raising voluntary assisted dying
15. Person must make three separate requests
16. Must have written request [witnessed in the presence of a medical practitioner]
17. Two independent witnesses to request [exclusions for family members, beneficiaries, paid providers]
18. Specified time must elapse between requests [first and third requests must be at least 10 days apart with exception when death imminent]
19. Additional time required to elapse between steps of completing process [second assessment and third request must be at least one day apart
20. Must use independent accredited interpreter [if an interpreter is required]
21. No obligation to proceed, may withdraw at any time

Assessment

22. Eligibility and voluntariness assessed by medical practitioners
23. Must be two separate and independent assessments by medical practitioners
24. Assessing medical practitioners must have high level of training/experience
25. Assessing medical practitioners must have undertaken prescribed training [to identify capacity and abuse issues]
26. Requirement to properly inform person of diagnosis, prognosis and treatment options, palliative care, etc, [by both assessing medical practitioners]
27. Referral for further independent assessment if there is doubt about decision-making capacity
28. Coordinating medical practitioner must confirm in writing that they are satisfied that all of the requirements have been met

Medication management

29. Person required to appoint contact person who will return medication if unused
30. Medical practitioner must obtain a permit to prescribe the medication to the person
31. Medication must be labelled for use, safe handling, storage and disposal
32. Pharmacist also required to inform the person about administration and obligations
33. Medication must be stored in a locked box

Administration

34. Medication must be self-administered [except in exceptional circumstances]
35. If physical incapacity, medical practitioner may administer
36. Additional certification required if administered by medical practitioner
37. Witness present if medical practitioner administers

Practitioner protections

38. Health practitioner may conscientiously object to participating
39. Explicit protection for health practitioners who are present at time of person self-administering
40. Explicit protection for health practitioners acting in good faith without negligence within the legislation
41. Mandatory notification by any health practitioner if another health practitioner acting outside legislation
42. Voluntary notification by a member of the public of a health practitioner acting outside legislation

Mandatory reporting

43. Reporting forms set out in legislation
44. Reporting mandated at a range of points and from a range of participants to support accuracy
45. First assessment reported [to Board]
46. Second assessment reported [to Board]
47. Final certification for authorisation reported [to Board, incorporates written declaration and contact person nomination]
48. Additional form reported [to Board] if medication administered by medical practitioner
49. Prescription authorisation reported by DHHS [to Board]
50. Dispensing of medication reported [to Board]
51. Return of unused medication to pharmacist reported [to Board]
52. Death notification data reported [to BDM and collected by Board]

Offences

53. New offence to induce a person, through dishonesty or undue influence, to request voluntary assisted dying
54. New offence to induce a person, through dishonesty or undue influence, to self-administer the lethal dose of medication
55. New offence to falsify records related to voluntary assisted dying
56. New offence of failing to report on voluntary assisted dying
57. Existing criminal offences for the crimes of murder and aiding and abetting suicide continue to apply to those who act outside the legislation

Oversight

58. Guiding principles included in legislation
59. Board is an independent statutory body
60. Board functions described in legislation
61. Board reviews compliance
62. Board reviews all cases of [and each attempt to access] voluntary assisted dying
63. Board has referral powers for breaches
64. Board also has quality assurance and improvement functions
65. Board has expanded multidisciplinary membership
66. Board reports to publicly [to Parliament every six months for first two years, thereafter annually
67. Five year review of the legislation
68. Guidelines to be developed for supporting implementation

 

Keywords: 

Assisted dying (AD) | Australia | Victoria | Legislative reform

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